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Re: Lou's reply-hynuen-Robert_Burton_1621 Lou Pilder

Posted by Robert_Burton_1621 on March 4, 2015, at 6:32:25 [reposted on March 14, 2015, at 22:17:23 | original URL]

In reply to Lou's reply-hynuen-Robert_Burton_1621, posted by Lou Pilder on March 4, 2015, at 5:42:21

> > > Robert,
> You say that you do not follow my logic. I say to you that what you have posted here could result in the deaths or addictions or life-ruining conditions to other readers here and I am asking that we have an immediate discussion here.

Lou, your assertion is misleading, inflammatory and unfair. Nothing I posted "could result in" (i.e., be relevantly causally related to) any of the terrible consequences that you imply in your statement would flow naturally from the post I made.


>This is all because the psychiatrist that operates this forum is allowing your claims here to be seen as supportive and I think otherwise,>

The psychiatrist who operates this forum imposes as a condition of participation that no-one infers from the posts published here that medical advice is being supplied. The purpose of this forum is not in the online supply of clinical advice on which participants are intended to act but in describing, and thinking out-loud about, medication problems and *possible* medication strategies that participants might *think over*. No post here carries the express or implied intention or expectation that the content of any post should be acted upon *because* of any assumed expertise in the poster or because the reader has read the post here. Indeed, such expectations are very properly, and responsibly, expressly excluded by Dr Hsiung.

>and your claim that Mirtazapine is used to treat SS, and that the site drugs.com has erroneous information is what is in issue here.>

I never "claimed" that Mirtazapine "is used" (i.e., in the ordinary meaning of that aspect of the tense you have chosen to express my original comment in, habitually) to treat serotonin toxicity. I said that it "has been used" to treat such toxicity; and I say further than an authority argues persuasively that the serotonergic potency of mirtazapine is low to negligible in humans, a fact which the safe combination of venlafaxine and mirtazapine appears to bear out: see Human Psychopharmacology: Clinical and Experimental, (2006) 21, pp 117-25.

You produce accurately my claim, based in my experience, that the drug interaction section of drugs.com *has* erroneous information. I.e., that occassionally its information is erroneous in the level of detail it provides. Yet you then proceed, in one of your highly tendentiously phrased questions, to assert that I claimed that drugs.com is not "based on facts". I never claimed such a thing, nor did I ever claim to profess to a degree of knowledge of the entirety of drugs.com beyond my experience of it. My knowledge that it sometimes throws up erroneous information derives, in the instance to which I adverted, from its assertion that the combination of mirtazapine and venlafaxine poses a *major* risk of serotonin toxicity. Drugs.com also asserts that the combination of tranylcypromine and nortriptyline poses a *major* risk of serotonin syndrome, an assertion that is inconsistent with a clinical assessment of the pharmacological mechanisms of each drug. I would pose in reply to you the challenge to produce a citation which demonstrates this information to be accurate.

Most certainly did I not assert, or imply, that drugs.com contains information that is *always* or *mostly* erroneous. Not did I ever suggest that drugs.com should not be used or consulted. My point was that it is *better* to refer to specialist views rather than generic information as provided by drugs.com *exclusively*. Drugs.com may be a first port of call, but it shouldn't be the only one.


> If you could post answers to the following then by my responses I could address your claims here in what I think could save livesprevent life-ruining conditions and addictions.

I do not propose to oblige you in this matter, given the tendentious and quite frankly deeply offensive way you have chosen to phrase your questions. Your purpose is not, clearly, fair-mindedly to elicit clarifications but to inflame prejudice. My answers are as provided above.

I note that you have had a habit of delivering yourself of outrageously unfair imputations against Dr. Hsiung. I do not propose to engage with you further given the nature of the imputations you have chosen to direct at myself.

It may also be as well to remind you that the primary purpose of this thread is to offer responses to fido; it is not meant for you to indulge in the riding of eccentric hobby-horses.


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URL: http://www.dr-bob.org/babble/20150223/msgs/1077523.html